Choi Chang Hyun, Seok Hyun-Gyu, Park Sam-Guk
Department of Orthopedics, Yeungnam University Medical Center, Daegu 42415, Korea.
J Clin Med. 2022 Aug 24;11(17):4964. doi: 10.3390/jcm11174964.
The ulnar coronoid process plays a key role in maintaining elbow stability; however, there is no gold standard treatment for ulnar coronoid process fractures. We present a novel surgical technique, arthroscopic reduction and bent K-wire fixation, for type II and III coronoid process fractures according to the O'Driscoll classification. Five patients were treated and retrospectively reviewed between January 2016 and December 2019. All the surgeries were performed by a single surgeon. We evaluated clinical outcomes by evaluating a range of motion, disability of arm, shoulder, and hand (DASH) score, Mayo Elbow Performance score (MEPS), and radiographic images. Intraoperative and postoperative radiographs showed that the fractures healed well and were satisfactorily fixed. The average elbow extension/flexion was -3/130, with an average DASH score of 2.42 and MEPS of 97. Coronoid process fractures can be treated successfully with arthroscopic reduction and fixation of bent K-wire, which allows more rigid fixation and early functional exercise, resulting in good outcomes without special tools.
尺骨冠状突在维持肘关节稳定性方面起着关键作用;然而,对于尺骨冠状突骨折尚无金标准治疗方法。我们根据O'Driscoll分类法,针对II型和III型冠状突骨折,提出了一种新的手术技术,即关节镜下复位及弯克氏针固定。2016年1月至2019年12月期间,对5例患者进行了治疗并进行回顾性分析。所有手术均由同一位外科医生完成。我们通过评估活动范围、上肢、肩部和手部功能障碍(DASH)评分、梅奥肘关节功能评分(MEPS)以及影像学图像来评估临床结果。术中及术后X线片显示骨折愈合良好且固定满意。平均肘关节伸展/屈曲角度为-3/130,平均DASH评分为2.42,MEPS为97。采用关节镜下弯克氏针复位固定治疗冠状突骨折可取得成功,该方法固定更牢固,可早期进行功能锻炼,无需特殊工具即可取得良好效果。